Provider Demographics
NPI:1326500885
Name:DELEON, LAURA LYNN
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:DELEON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 W LOOP 250 N STE C121
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-3257
Mailing Address - Country:US
Mailing Address - Phone:432-520-5566
Mailing Address - Fax:432-520-2152
Practice Address - Street 1:3001 W LOOP 250 N STE C121
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-3257
Practice Address - Country:US
Practice Address - Phone:432-520-5566
Practice Address - Fax:432-520-2152
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80731237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist